Trial reportJournal of the National Cancer Institute2016
Comparing Breast Cancer Multiparameter Tests in the OPTIMA Prelim Trial: No Test Is More Equal Than the Others.
Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in Journal of the National Cancer Institute, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 1 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
90 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Gene expression profiling tests to guide adjuvant chemotherapy decisions in lymph node-positive early breast cancer: a systematic review.Breast cancer research and treatment · 2025Pooled it
- The spatially informed mFISHseq assay resolves biomarker discordance and predicts treatment response in breast cancer.Nature communications · 2025Trial
- Breast Cancer Index Is a Predictive Biomarker of Treatment Benefit and Outcome from Extended Tamoxifen Therapy: Final Analysis of the Trans-aTTom Study.Clinical cancer research : an official journal of the American Association for Cancer Research · 2022Trial
- Decision of adjuvant chemotherapy in intermediate risk luminal breast cancer patients: A prospective multicenter trial assessing the clinical and psychological impact of EndoPredict® (EpClin) use (UCBG 2-14).Breast (Edinburgh, Scotland) · 2020Trial
- Discrepancies in central review re-testing of patients with ER-positive and HER2-negative breast cancer in the OPTIMA prelim randomised clinical trial.British journal of cancer · 2017Trial
- Advances in Breast Cancer Diagnostics: From Screening to Precision Medicine.Diagnostics (Basel, Switzerland) · 2026Review
- Independent prognostic value of the gene-only BCT Score compared with the 21-gene recurrence score in ER+/HER2- early breast cancer.Frontiers in oncology · 2026Article
- Therapy of early breast cancer: current status and perspectives.Archives of gynecology and obstetrics · 2025Review
- Biomarkers in prostate cancer: current status and future directions in radiotherapy-statement from the Prostate Cancer Working Group of the German Society of Radiation Oncology (DEGRO).Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Review
- Genomic characterization of the HER2-enriched intrinsic molecular subtype in primary ER-positive HER2-negative breast cancer.Nature communications · 2025Article
- The Breast Cancer Classifier refines molecular breast cancer classification to delineate the HER2-low subtype.NPJ breast cancer · 2025Article
- Prediction of post-treatment recurrence in early-stage breast cancer using deep-learning with mid-infrared chemical histopathological imaging.NPJ precision oncology · 2025Article
- Clinician's guide: expert insights on the use of CDK4/6 inhibitors in patients with early breast cancer.Therapeutic advances in medical oncology · 2025Review
- Evaluating an RNA-based test for proliferation assessment and recurrence prediction in early HR+/HER2- breast cancer.Pathology oncology research : POR · 2025Article
- Validation of an AI-based solution for breast cancer risk stratification using routine digital histopathology images.Breast cancer research : BCR · 2024Article
- Clinical evaluation of deep learning-based risk profiling in breast cancer histopathology and comparison to an established multigene assay.Breast cancer research and treatment · 2024Article
- Performance of a novel spectroscopy-based tool for adjuvant therapy decision-making in hormone receptor-positive breast cancer: a validation study.Breast cancer research and treatment · 2024Article
- Identification of Patients with Early HR+ HER2- Breast Cancer at High Risk of Recurrence.Geburtshilfe und Frauenheilkunde · 2024Article
- Use of the Gene Expression Test ProsignaBreast care (Basel, Switzerland) · 2024Article
- Gene-Expression Profiling to Decipher Breast Cancer Inter- and Intratumor Heterogeneity.Cold Spring Harbor perspectives in medicine · 2024Review
30 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
21 authors.
John M S BartlettOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS). john.bartlett@oicr.on.ca.
Jane BayaniOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Andrea MarshallOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Janet A DunnOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Amy CampbellOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Carrie CunninghamOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Monika S SobolOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Peter S HallOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Christopher J PooleOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
David A CameronOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Helena M EarlOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Daniel W ReaOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Iain R MacphersonOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Peter CanneyOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Adele FrancisOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Christopher McCabeOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Sarah E PinderOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Luke Hughes-DaviesOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Andreas MakrisOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
Robert C SteinOntario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB, JB); University of Toronto, Toronto, Canada (JMSB); University of Edinburgh, Edinburgh, UK (JMSB, CC, MSS, PSH, DAC); Warwick Clinical Trials Unit, University of Warwick, Coventry, UK (AM, JAD, AC); University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK (CJP); University of Cambridge Department of Oncology and NIHR Cambridge Biomedical Research Centre, Cambridge, UK (HME); Cancer Research UK Institute for Cancer Studies, University of Birmingham, Birmingham, UK (DWR); University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK (IRM, PC); University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK (AF); University of Alberta, Edmonton, AB, Canada (CM); Kings College London, Guy's Hospital, London, UK (SEP); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK (LHD); Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Middlesex, UK (AM); National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, UK (RCS).
OPTIMA TMG
Funding
Department of Health 10/34/01Department of Health RP-PG-0707-10101
Abstract
backgroundPrevious reports identifying discordance between multiparameter tests at the individual patient level have been largely attributed to methodological shortcomings of multiple in silico studies. Comparisons between tests, when performed using actual diagnostic assays, have been predicted to demonstrate high degrees of concordance. OPTIMA prelim compared predicted risk stratification and subtype classification of different multiparameter tests performed directly on the same population.
methodsThree hundred thirteen women with early breast cancer were randomized to standard (chemotherapy and endocrine therapy) or test-directed (chemotherapy if Oncotype DX recurrence score >25) treatment. Risk stratification was also determined with Prosigna (PAM50), MammaPrint, MammaTyper, NexCourse Breast (IHC4-AQUA), and conventional IHC4 (IHC4). Subtype classification was provided by Blueprint, MammaTyper, and Prosigna.
resultsOncotype DX predicted a higher proportion of tumors as low risk (82.1%, 95% confidence interval [CI] = 77.8% to 86.4%) than were predicted low/intermediate risk using Prosigna (65.5%, 95% CI = 60.1% to 70.9%), IHC4 (72.0%, 95% CI = 66.5% to 77.5%), MammaPrint (61.4%, 95% CI = 55.9% to 66.9%), or NexCourse Breast (61.6%, 95% CI = 55.8% to 67.4%). Strikingly, the five tests showed only modest agreement when dichotomizing results between high vs low/intermediate risk. Only 119 (39.4%) tumors were classified uniformly as either low/intermediate risk or high risk, and 183 (60.6%) were assigned to different risk categories by different tests, although 94 (31.1%) showed agreement between four of five tests. All three subtype tests assigned 59.5% to 62.4% of tumors to luminal A subtype, but only 121 (40.1%) were classified as luminal A by all three tests and only 58 (19.2%) were uniformly assigned as nonluminal A. Discordant subtyping was observed in 123 (40.7%) tumors.
conclusionsExisting evidence on the comparative prognostic information provided by different tests suggests that current multiparameter tests provide broadly equivalent risk information for the population of women with estrogen receptor (ER)-positive breast cancers. However, for the individual patient, tests may provide differing risk categorization and subtype information.
Indexed as
Decision Support TechniquesAdultAgedAntineoplastic Agents, HormonalAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsClinical Decision-MakingConfidence IntervalsErb-b2 Receptor Tyrosine KinasesFemaleHumansLymphatic MetastasisMiddle AgedNeoplasm Recurrence, LocalNomogramsPredictive Value of TestsAntineoplastic Agents, HormonalERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, Estrogen
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